A new report, conducted by professional services firm CliftonLarsonAllen LLP (CLA), finds that the proposed mandate would cost nursing homes approximately $6.8 billion per year–higher than the $4 billion per year estimate from the Centers for Medicare & Medicaid Services (CMS).
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The proposed rule would require specific nursing home staff to spend a minimum number of hours with each resident–2.45 nurse aide hours per resident per day (HPRD) and 0.55 registered nurse (RN) HPRD–as well as have a RN on site 24 hours a day. The CLA report found that if the proposal is finalized, nursing homes would need to hire an estimated 102,154 additional full-time employees (80,077 nurse aides and 22,077 RNs).
The report also found:
- The majority (94 percent) of nursing homes currently do not meet at least one of the three proposed staffing requirements.
- Of the 94 percent, 36 percent of facilities are not meeting all three requirements; 34 percent are not meeting two of the requirements; and 24 percent are not meeting one of the requirements.
- Nursing homes that did not meet at least one of the requirements were more likely to have most of their residents relying on Medicaid (56 percent average Medicaid census) compared to facilities that met the criteria (43 percent).
- If nursing homes are unable to increase their workforce to meet these new requirements, more than 280,000 nursing home residents, or nearly one-quarter of all residents, could be impacted by census reductions.
The report comes in the wake of a recent KFF analysis that found 81 percent of nursing facilities would need to hire additional staff to comply with new nursing staff requirements. Under the proposed rule, 19 percent of nursing facilities would currently meet the minimum staff hours for registered nurses and nurse aides.
RELATED: KFF: 1 in 5 nursing facilities would meet proposed requirements for nursing staff hours
“What CLA’s analysis confirms is that this proposed rule is deeply flawed, and the Biden administration has woefully underestimated the feasibility and cost of this unfunded mandate,” said AHCA/NCAL President and CEO Mark Parkinson in the study announcement. “When nearly every nursing home in the country would be considered out of compliance if this went into effect today, it demonstrates how out of touch Washington bureaucrats are with reality. Nursing homes are already grappling with a growing caregiver shortage; to demand they hire 100,000 additional caregivers, without any meaningful resources or support, is a disservice to our nation’s seniors. We all want to grow the nursing home workforce, but this impossible policy is absolutely not the way to do it.”